Fistic Medicine: HGH Testing

The names on the lips of those interested in the science of MMA in
the last month were not Penn and Diaz, but Issa and Newton. Darryl
Issa is one of the Congressmen demanding the National Football
League initiate testing for Human Growth Hormone this season. Terry
Newton is the British rugby player who, in November 2009, became
the first professional athlete ever to test positive for illegal
use of HGH.

Congressman Issa’s crusade should be of interest to MMA fans
because the NFL leads the way in many issues that affect combat
sports: testing for performance-enhancing drugs, healthcare, brain
injury, etc. Whatever happens in that arena will inevitably trickle
down into renewed interest in HGH testing for MMA.

HGH is a hormone secreted by a tiny gland in the brain known as the
Pituitary. For many years, synthetic growth hormone has been
available as a medical treatment for growth hormone deficiency, a
condition that leaves children profoundly underdeveloped and leads
to physical decline in adults. HGH increases size, strength and
promotes tissue healing: it is a natural drug for athletes,
particularly combat athletes, to avail themselves of. It is
suspected that synthetic HGH has been used by elite athletes since
the 1970s, and, yet, for 30 years, there was no reliable test for
illegal HGH use in sports. Congressional pressure notwithstanding,
there may still not be.

There are two primary problems with the current HGH testing scheme
the World Anti-Doping Agency is urging on the NFL and state
athletic commissions. The first is that a blood sample is required
-- HGH exists in the blood at a hundred times greater concentration
than in urine. The challenge and invasiveness of obtaining and
handling samples is vastly greater for blood than for urine
testing, which is the athletic commission standard. More
problematic is the very short half-life of HGH in the body: about
2.5 hours. A day after injecting HGH, serum levels are 0.1 percent
of the injection dose, and a week after using HGH, the drug is
completely gone from the system.

The WADA test is, in effect, not an HGH test, but an I.Q. test --
catching only those who cannot figure out how simple it is to
evade. When Newton admitted to HGH use, he stated: “I have made a
grave error of judgment in taking a banned substance and hope that,
if nothing else, my stupidity will be a warning to any other
professional in any sport of the consequences of doing so.” Surely,
some athletes reacted to the first phrase, reconsidering their own
use of HGH, but just as surely, others heard only the last phrase
and recommitted themselves to not being “stupid” and needlessly
getting caught.

WADA’s answer to the limitations of their HGH test is to utilize
“intelligence” and out-of-competition testing; “intelligence” in
the espionage sense of the word, as in secret information about an
athlete’s HGH usage: anonymous tips from disgruntled
ex-girlfriends, reports from poorly compensated training partners,
confessions from doctors implicated in drug dealing.
Out-of-competition testing requires athletes to register their
whereabouts with WADA and make themselves available on short notice
for testing. One can imagine an athlete’s distaste at being
subjected to a system where any confidante is a potential informer
and in which registration regulations can be stricter than those
for sex offenders.

These are legitimate issues, as is the cost -- an estimated $80,000
for a fighter’s training camp. The most anticipated boxing match of
the past decade fell apart over differences in how fighters viewed
WADA testing protocols. Floyd Mayweather Jr. judged the cost and
invasiveness of testing worth the benefits. Manny Pacquiao did
not.

WADA’s best answer for the critics of HGH testing lies in the
future. The organization has spent millions developing a test it
hopes will detect the drug, not one or two days after use but as
much as three weeks out. Somewhere down the line, WADA hopes for
cheap, easy urine tests. The promise of these future advancements
has been enough to convince Congressmen Issa, but not the NFL
Players Union or athletic commission heads like Nevada State
Athletic Commission Executive Director Keith Kizer.

“[On] HGH blood test, they’ve done thousands of tests and they’ve
only caught one guy,” Kizer stated in May 2010, when the Nevada
commission last considered HGH testing. “Either he is the only guy
doing HGH or there are a lot of false negatives.”

The question men like Kizer are asking but which WADA is not
required to consider is will HGH testing help fighters and not
merely “purify” the sport? Is it right to subject hundreds, if not
thousands, of fighters to the disadvantages of testing if only one
in a hundred or one in a thousand cheaters will actually be
caught?

Those of us who are advocates of aggressive drug testing in sports
have a tendency to ignore or minimize the human costs of testing.
We focus on the dangers of drug use, on the risk of PEDs filtering
down from the professional ranks into the lives and bodies of high
school athletes, on the purity of sport. However, the human costs
of testing are far from trivial. After failing an HGH test that he
quite likely could have effectively contested in court, Newton lost
his job and ended a successful career. Seven months after being
sanctioned, he walked into the garage in which he had injected
himself with HGH for years and hanged himself. He was 31.

At the very least, a better test is deserved by everyone.

Matt Pitt is a physician with degrees in biophysics and
medicine. He is board-certified in emergency medicine and has
post-graduate training in head injuries and multi-system trauma. To
ask a question that could be answered in a future article, e-mail
him at mpitt@sherdog.com.